Organization
PHENIX PSYCHIATRIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER TAWA NP (MANAGING PSYCHIATRIC NP)
(603) 930-4746
Entity
Organization
Contact information
Practice address
109 RIVERWAY PL, BEDFORD, NH 03110-6730
(978) 226-8690
Mailing address
109 RIVERWAY PL, BEDFORD, NH 03110-6730
(978) 226-8690
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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